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General NPI Number Information
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NPI Number | 1639496268
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE CARE FOR WOMEN PLLC
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Dates
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Enumeration Date | 04/21/2010
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Last Update Date | 04/21/2010
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Provider Practice Location Address
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Address Line | 2945 S DOBSON RD
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City | MESA
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State | AZ
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Zip | 85202-7980
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Country | US
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Telephone | 480-699-2508
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Fax | 480-699-2530
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Provider Business Mailing Address
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Address Line | PO BOX 51355
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City | PHOENIX
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State | AZ
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Zip | 85076-1355
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Country | US
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Telephone | 480-699-2508
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Fax | 480-699-2530
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | HEIDI U. RULA
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Credential | M.D.
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Telephone | 480-699-2508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 23893
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License Number State | AZ
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